On the other hand, the high proportion of ANP may be associated with the DENV invasion of acinar cells, which are ultimately destroyed, and/or immune-mediated inflammatory damage and/or microvascular ischemia due to increased vascular permeability associated with DENV infection [64,69,71,106], possibly explaining the higher levels of serum amylase compared to AIP cases. This evidence concerns the gene NPPA and autoimmune pancreatitis.